• Abstract and Figures
• Public Full-text

Initial Environmental Examination Project Number: 41376-02 September 2009 LAO: Health Sector Development Program Prepared by the Ministry of Health This report has been submitted to ADB by the Mini stry of Health and is made publicly available in accordance with ADB’s public communications policy (2005). It does not necessarily reflect the views of ADB. INITIAL ENVIRONMENTAL EXAMINATION (IEE) ABBREVIATIONS ACM – asbestos carrying materials ADB – Asian Development Bank AIDS – acquired immune deficiency syndrome ANC – antenatal care BOD – Biological oxygen demand CMR – child mortality ratio CPR – contraceptive prevalence rate DHO – district health office DOTS – directly observed treatment short course DPF – Department of Planning and Finance DRF – drug revolving fund EA – executing agency; environmental assessments EIA – Environmental impact assessment EARP – Environmental Assessment and Review Procedures EIAR – Environmental Impact Assessment Report EMP – Environmental Management Plan EmONC – emergency obstetric and neonatal care EU – European Union FIC – fully immunized child FDI – foreign direct investment GDP – gross domestic production GMS – Greater Mekong Subregion GOL – Government of Lao PDR Health SDP – Health Sector Development Program HEF – health equity fund HIV – human immunodeficiency virus HRD – human resource development HRH – human resources for health IA - Implementing Agency IEE - Initial Environmental Examination IEC – information, education and communication JFPR – Japan Fund for Poverty Reduction JICA – Japan International Cooperation Agency Lao PDR – Lao People’s Democratic Republic Lux Development – Luxembourg Development MDG – millennium development goal MFA – Ministry of Foreign Affairs MMR – maternal mortality rate MCH – maternal and child health MNCH – maternal, neonatal, and child health MOF – Ministry of Finance MOH – Ministry of Health MPI – Ministry of Planning and Investment NGO – non-government organization NGPES – National Growth and Poverty Eradication Strategy NSEDP6 – Sixth National Socio-economic Development Plan NT2 – Nam Theun 2 PASCA – Public Administration and Civil Service Authority PAH – Project affected household PHC – primary health care PHCEP – primary health care expansion project PCU – Project Coordination Unit PHO - Provincial Health Office PIA - Provincial Implementing Agency PM – Particulate matter PPTA – project preparatory technical assistance PRSO – Poverty Reduction Support Operation Project activity – All project sub-components at one location for the purposes of application of the EARPs Project component – One of total project loan components in the overall project loan Project sub- – Sub-component of the project component; either civil building component works, solid waste management facilities or wastewater treatment facilities UXO - Unexploded ordnance VHC – village health committee WHO – World Health Organization WHS – World Heritage Site VHV Village Health Volunteer WWTP – Wastewater treatment plant WREA _ Water Resources and Environment Administration WEIGHTS AND MEASURES Ha – Hectare Kg – Kilogram Km – Kilometer L / l – Liter m – Meter mg – Milligram μg – Microgram CONTENTS Page I. INTRODUCTION...............................................................................................................1 A. Background of the Project 1 B. Purpose and Structure of the Report 2 II. DESCRIPTION OF THE PROJECT..................................................................................3 A. Project Overview 3 B. Type of Project 3 C. Category of Project 3 D. Need for Project 4 E. Project Location 5 F. Project Components 5 G. Project Cost and Implementation Arrangements 8 III. DESCRIPTION OF THE ENVIRONMENT........................................................................9 A. Physical Resources 9 B. Ecological Resources 10 C. Economic Development 11 D. Social and Cultural Resources 13 IV. SCREENING OF POTENTIAL ENVIRONMENTAL IMPACTS AND MITIGATION MEASURES................................................................................................................................18 A. Environmental Assessment Methodology 18 B. Screening of Typical Environmental Impacts of Project Components 19 C. Sector Level Environmental Assessment 27 V. INSTITUTIONAL REQUIREMENTS AND ENVIRONMENTAL MONITORING PLAN ....28 A. Institutional Arrangements 28 B. Environmental Mitigation Plan 29 C. Environmental Monitoring Plan 32 D. Environmental Monitoring and Reporting 34 E. Environmental Management Budget 34 VI. PUBLIC CONSULTATION AND INFORMATION DISCLOSURE ...................................35 A. Public Consultation Undertaken to Date 35 B. Future Public Consultation and Disclosure 40 VII. ENVIRONMENTAL ASSESSMENT AND REVIEW PROCEDURES..............................40 A. Introduction 40 B. Overview of Types of Project Sub-Components to be Assessed 41 C. Lao PDR’s Environmental Assessment and Review Procedures 41 D. Specific Procedures to be used for Project Sub-components under the Sector Development Grant 41 VIII. FINDINGS AND RECOMMENDATIONS ........................................................................47 A. Findings 47 B. Recommendations 48 IX. CONCLUSIONS..............................................................................................................48 X. REFERENCES................................................................................................................49 APPENDICES 1. Management Principles for Handling and Removal of Asbestos 2. Proposed Health Care Waste Management Principles 3. Details of Public Consultation Activities TABLES Table3.1 Administrative Units in Project Provinces ....................................................................12 Table3.2 Poverty in Project Provinces .......................................................................................13 Table3.3 MNCH Health Indicators in Project Area (per 100,000) ...............................................14 Table3.4 Health Establishments under Ministry of Health in Project Areas................................14 Table3.5 Decreed and Proposed Cultural/Historical Sites in Lao PDR ......................................18 Table 4.1: Environmental Screening of Structural Sub-Components...................................19 Table 5.1: Environmental Management Institutional Arrangements.....................................28 Table 5.2: Environmental Mitigation Plan.............................................................................29 Table 5.3: Environmental Effects Monitoring Plan................................................................32 Table 5.4: Environmental Performance Monitoring Plan......................................................33 Table 5.5: Environmental and Monitoring Reporting Requirements.....................................34 Table 7.1: Environmental Impacts and Mitigation Measures................................................42 Table 7.2: Environmental Effects Monitoring Plan................................................................45 Table 7.3: Environmental Performance Monitoring Plan......................................................45 FIGURES Figure 1: Lao PDR Map..........................................................Error! Bookmark not defined. 1 I. INTRODUCTION A. Background of the Project 1. The Lao PDR has made good progress toward the health-related MDGs 1, 4, and 5. Under the stewardship of the Ministry of Health (MOH), significant progress has been made in its strategy to expand the PHC network in Lao PDR in the past eight years. By 2008, there were already 126 district hospitals, 789 centers servicing 51% of all villages (on average, one health center services 8 villages), and nearly 13,820 Village Health Volunteers in 5,668 villages with drug kits for villages that are more than 2 hours walking distance to the nearest fixed health facility. Good progress has been made in reducing infant and under-five mortality, and halting increases in HIV/AIDS, malaria, and TB. Access to safe water has surpassed MDG targets and access to latrines will likely achieve its target. 2. Despite this progress, however, maternal mortality remains unacceptably high, too few women are assisted by skilled health personnel when they deliver, and under-nutrition in children persists. Ethnic minorities and large segments of the population living in remote, scattered, and isolated areas remain underserved with affordable and high quality health services. The quality, quantity, and skill mix of the health workforce do not meet required standards. The Mid-term Review of the 6th HSDP identified that chief among the challenges in the health sector is that the supply of health services is not keeping pace with rapidly increasing demand. 3. To assist the GOL to address these identified challenges the ADB is proposing to finance the Health Sector Development Program with a grant comprised of a program and project component to continue supporting the gains of the health sector. The project component would be implemented in six provinces1 and will upgrade and improve the civil works facilities of 8 district hospitals2 and 25 health centers3. The sub-projects will have a direct impact on the reduction of maternal and child mortality as part of the coordinated actions to address health sector development constraints in the northern and southern provinces. IEE was carried out for the 8 priority hospitals and selected health centers contributing to Output 2, increased access to health services for mothers, children and ethnic groups.

Load more

  63

Copy Link